Question 1

What is HCPCS code C1604?

Accepted Answer

HCPCS code C1604 is "Grft, trnsmurl/trnsvens byps". Graft, transmural transvenous arterial bypass (implantable), with all delivery system components

Question 2

What category is C1604 in?

Accepted Answer

C1604 belongs to HCPCS Category C (CMS Hospital Outpatient Payment).

Question 3

When should I use HCPCS code C1604?

Accepted Answer

Use C1604 when billing for grft, trnsmurl/trnsvens byps. HCPCS Level II codes like this are used for items and services not covered by CPT codes, including medical supplies, equipment, drugs administered in clinical settings, and certain healthcare services.

Question 4

Is C1604 covered by Medicare?

Accepted Answer

Coverage for C1604 (Grft, trnsmurl/trnsvens byps) depends on medical necessity and specific Medicare guidelines. Check the applicable Local Coverage Determination (LCD) or National Coverage Determination (NCD) for detailed coverage criteria. Private insurers may have different coverage policies.

Question 5

What documentation is required for C1604?

Accepted Answer

Documentation for C1604 should include: the medical necessity for the item or service, supporting diagnosis codes (ICD-10), prescription or order from the treating physician, and proof that the item meets quality standards. Some items may require additional documentation like a Certificate of Medical Necessity (CMN).